1. Field
This application relates generally to medical instruments, particularly surgical forceps for examinations and operations. This application further relates to vasectomy forceps. This application also relates to performing a vasectomy.
2. General Background and State of the Art
Vasectomy is a male birth control surgical procedure that involves severing the vas deferens and tying and/or sealing the ends, preventing the entry of sperm into the seminal stream. The procedure is often carried out in a physician's office or clinic and is done under local anesthesia. The two widely used methods for performing a vasectomy are “traditional” and “no-scalpel.”
In the “traditional” method, the surgeon makes an incision on the scrotum to access and directly clamp the vas deferens. The surgeon then occludes a small piece of the vas deferens and seals the ends by suturing, cauterizing or applying surgical clips, or employing a combination of sealing methods. The procedure is done for both vas deferentia.
The “no-scalpel” method involves the surgeon accessing the vas deferens by puncturing the scrotum with a sharp hemostat, usually after clamping the vas deferens through the scrotal skin. The surgeon first locates the vas deferens through the scrotum, typically by rolling the vas deferens between the thumb, index and middle fingers. Efficiency in locating the vas deferens by feel requires experience. Once the vas deferens has been located and isolated from other structures through the scrotal skin, it is pushed toward the surface to enable clamping. In general practice, the surgeon uses one finger on the underside of the pinched scrotal skin to push the vas deferens between his two fingers on the opposing (upper) side. This forces a segment of the vas deferens to a position close to the surface where it can be clamped.
The vas deferens is exposed from the puncture site using various forceps. The surgeon then occludes the vas deferens and seals the severed ends by suturing, cauterizing or applying surgical clips, or employing a combination of sealing methods. The procedure is done for both vas deferentia. No-scalpel vasectomy was disclosed in detail in a document entitled “No-Scalpel Vasectomy. A Training Course for Vasectomy Providers and Assistants” 2nd Edition, published by EngenderHealth in 2007. Entire content of this document is incorporated herein by reference.
Various types of vasectomy forceps used to clamp the vas deferens are available in the market. Most forceps used in vasectomies consist of an intersecting pair of scissoring arms with a ratcheting mechanism to maintain the desired clamping pressure and tips shaped to grasp the tissue (in this case the vas deferens) in a certain way. For example, the distal end of the ring-type vasectomy forceps consists of a single pair of half-hooks on opposing arms that come together to form a ring, between which the vas deferens is clamped. Often, several types of forceps are used in a single procedure. A plurality of forceps may be used simultaneously to clamp the exposed vas deferens at two locations, enabling the surgeon to occlude and seal the vas deferens between two clamped points.
The following are a few types of commonly used vasectomy forceps available in the market: ring-type (cantilevered or non-cantilevered); teardrop; ball-end (non-penetrating); hemostat (Mosquito forceps—Halstrad or Kelly; curved or straight); and tissue forceps (Allis forceps or surgical tweezers).
Several problems with current tools and methods of no-scalpel vasectomy exist. For example, the wrist action currently required to push the vas deferens to the surface of the scrotum feels unnatural, is uncomfortable, and is difficult to maintain. Furthermore, the use of the index finger, middle finger, or tip of the thumb to push the vas deferens between the other two fingers provides little tactile surface against the vas deferens, making isolation and positioning of the vas deferens difficult.
Additionally, existing forceps require much maneuvering and transferring of the vas deferens between different forceps throughout the procedure, in order to occlude and seal the vas deferens on both sides of the clamp.
Furthermore, during surgery, the surgeon typically locates the vas deferens from the exterior of the scrotum by rolling the vas deferens between the fingers and thumb. Once the vas deferens is located and the segment is pushed outward towards the surgeon, the approach direction for clamping the vas deferens is often from the side (along the patient's abdomen) rather than from the top of the patient. The grasping and clamping of the vas deferens with a straight tool in this position typically make it cumbersome for the surgeon. Use of a straight tool would further occlude the intended clamping site.